Thrombotic thrombocytopenic purpura in a human immunodeficiency virus (HIV)-seropositive homosexual man

A case of thrombotic thrombocytopenic purpura (TTP) in a human immunodeficiency virus (HIV)-seropositive homosexual man is reported. The patient improved after corticosteroid and plasma exchange therapy was instituted. The case demonstrated most of the classic features of TTP, including histologic evidence of fibrin thrombi in small blood vessels. Atypical features included reduced number of megakaryocytes in the bone marrow and only partial resolution of thrombocytopenia after therapy was begun. An autoimmune thrombocytopenia has been well-characterized in HIV-antibody-seropositive homosexual men. Physicians caring for HIV-seropositive persons should also be aware of a possible association with TTP.